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Maternal obesity and excess risk of perinatal mortality: evidence from a large biracial population

No. 81 March 1994
MATERNAL OBESITY AND EXCESS RISK OF PERINATAL
MORTALITY: EVIDENCE FROM A LARGE BIRACIAL POPULATION
by
Elizabeth Barnett
David A. Savitz
Irva Hertz-Picciotto
ABSTRACT
To investigate the riskofperinatal death associatedwith maternal obesity, a cohort oflow-incomewomen
who participated in the North Carolina WIC program during 1 988-90 was evaluated retrospectively. Blacks
(N=45,65 1 ) and Whites (N=40,929) were considered separately. Perinatal mortality rate ratios for moderate
overweight and obesity were calculated using normal weight women as the referent group. A logistic
regression analysis provided adjusted estimates of the relative risks of perinatal mortality associated with
maternal overweight and obesity.
Maternal obesity was associated with an excess risk ofperinatal death among both Blacks (RR=1 .3) and
Whites (RR=1 .5), after adjustment for maternal age, education, parity, cigarette smoking, gestational weight
gain, diabetes and hypertension. There was no overall elevated risk of perinatal death among infants of
moderately overweight women for either Blacks or Whites. For both race groups, stronger associations of
maternal obesity with perinatal mortality were observedamongwomen less than 1 8 years old, women 3 5 years
or older, and women with adequate or excessive gestational weight gain.
The results ofthis study confirm that obesity is a major risk factor for perinatal mortality, not solely due
to risk factors associated with obesity, such as diabetes and hypertension. The high prevalence of obesity
among low-income women, which leads to high rates of chronic disease in later life, adversely affects
reproductive outcomes as well.
N.C.' DO \TS
CLE: ' HOUSE
MAY 20 1994
M*A DEMtMFt
*A\ NORTH CAROLINA DEPARTMENT OF ENVIRONMENT. HEALTH, AND NA^LJRAL BE^^e^SjQRARY
RALEiGH

No. 81 March 1994
MATERNAL OBESITY AND EXCESS RISK OF PERINATAL
MORTALITY: EVIDENCE FROM A LARGE BIRACIAL POPULATION
by
Elizabeth Barnett
David A. Savitz
Irva Hertz-Picciotto
ABSTRACT
To investigate the riskofperinatal death associatedwith maternal obesity, a cohort oflow-incomewomen
who participated in the North Carolina WIC program during 1 988-90 was evaluated retrospectively. Blacks
(N=45,65 1 ) and Whites (N=40,929) were considered separately. Perinatal mortality rate ratios for moderate
overweight and obesity were calculated using normal weight women as the referent group. A logistic
regression analysis provided adjusted estimates of the relative risks of perinatal mortality associated with
maternal overweight and obesity.
Maternal obesity was associated with an excess risk ofperinatal death among both Blacks (RR=1 .3) and
Whites (RR=1 .5), after adjustment for maternal age, education, parity, cigarette smoking, gestational weight
gain, diabetes and hypertension. There was no overall elevated risk of perinatal death among infants of
moderately overweight women for either Blacks or Whites. For both race groups, stronger associations of
maternal obesity with perinatal mortality were observedamongwomen less than 1 8 years old, women 3 5 years
or older, and women with adequate or excessive gestational weight gain.
The results ofthis study confirm that obesity is a major risk factor for perinatal mortality, not solely due
to risk factors associated with obesity, such as diabetes and hypertension. The high prevalence of obesity
among low-income women, which leads to high rates of chronic disease in later life, adversely affects
reproductive outcomes as well.
N.C.' DO \TS
CLE: ' HOUSE
MAY 20 1994
M*A DEMtMFt
*A\ NORTH CAROLINA DEPARTMENT OF ENVIRONMENT. HEALTH, AND NA^LJRAL BE^^e^SjQRARY
RALEiGH